Sexual Functioning Among HIV-Infected Women

From CDC National Prevention Information Network

April 3, 2003

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A unique set of issues is presented by the influence of HIV
infection on sexual activity and functioning. Few studies have
examined HIV-positive women's sexuality, and none have studied
the correlation between HIV symptoms, HIV illness stage, quality
of life, meaning of illness and sexual function. Fear of
reprisals as a result in engaging in less than optimal safe sex
practices causes many HIV-infected women to avoid discussing
sexual activity with health care providers.

The authors conducted a cross-sectional descriptive survey
with data from a study of adjustment to chronic illness among
HIV-positive women. Sexual functioning and activity were measured
as part of the study. One hundred thirteen women responded to
recruitment efforts and 101 (89 percent) completed the study.

Sexual activity and functioning were assessed using
questions developed through a review of existing literature on
sexual functioning and upon a pilot testing with HIV-positive
women regarding the most significant aspects of their sexual
health. Questions about sexual orientation, frequency of condom
use, and other safe sex practices were included in the interview.

Ninety percent of the women remained sexually active after
testing HIV-positive. Of these women, more than half reported
sexual activity within the past month (58 percent). For those
women not sexually active, reasons given included no current
partner (31 percent), no interest in sex (27 percent), because of
HIV (19 percent), physical symptoms (6 percent), partner not
interested (4 percent) and other (13 percent). Sexually active
HIV-positive women were more likely to be younger in age and have
more positive meaning associated with HIV infection.

Over half of the women reported that the quality of their
sexual activity had either stayed the same (31 percent) or
improved (21 percent) after testing positive for HIV. Only 11
percent reported that their sex life became significantly worse
after testing HIV positive.

Fifty-one percent of participants used condoms all of the
time when having sex. However, 25.4 percent reported never using
condoms during sexual activity and 37 percent reported using no
safe sex practices when engaged in sexual activity.

By exploring sexual activity, sexual functioning and safer
sex behavior, the study's findings illustrated several points.
First, although 90 percent of this sample continued to be
sexually active after testing positive for HIV, safer sex
practices remained low, with more than one-third engaging in
unprotected sexual activity on a regular basis. These findings
highlight the need for ongoing assessment by health care
providers regarding changes in sexual activity over time. Second,
among women, sexual functioning does not change as a function of
HIV illness stage and it cannot be assumed that women with
advanced HIV are not sexually active. Research and clinical
interventions to prevent sexual transmission need to be designed
that target women with advanced HIV. Finally, few women report
that HIV itself caused a decrease in sexual functioning. Women
with better mental health, more positive meaning attached to life
with HIV, better quality of life and no history of injection drug
use had higher levels of sexual functioning.

A note from TheBody.com: The field of medicine is constantly evolving. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

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